Electronic Claims &Electronic Funds Transfer (EFT)

Electronic Claims

Effective July 1, 2013, all network providers are required to submit claims electronically rather than by paper format. Submitting claims electronically will ensure compliance with the terms of the Minimum Practitioner Network Participation Criteria as well as lower costs and streamline adjudication. This effort is consistent with the health care industry's movement toward more standardized and efficient electronic processes.

Electronic Funds Transfer (EFT)

BlueCross BlueShield of Tennessee is pleased to be part of a new CAQH solution that enables providers to enroll in electronic funds transfer (EFT) and electronic remittance advice (ERA) with multiple payers through a single online process at no cost to the provider. The CAQH EFT/ERA enrollment tool offers providers a single point of entry for enrollment in electronic payments with multiple payers, including BlueCross BlueShield of Tennessee. The CAQH solution will facilitate compliance with the 2014 EFT/ERA mandate under the Affordable Care Act, eliminate administrative redundancies and create significant time and cost savings. Visit https://solutions.caqh.org to sign up today.

Effective April 1, 2013 all network providers are required to receive payments by Electronic Funds Transfer (EFT) to remain in compliance with the terms of the Minimum Practitioner Network Participation Criteria outlined in the Provider Administration Manual.

Key advantages to receiving electronic payments are:

Earlier payments;

More secure payment process;

Reduced administrative costs

Less paper storage.

More information regarding Electronic Funds Transfer (EFT) can be found here. Click here for assistance with Availity.